PerimenopauseMenopause Pelvic Floor Physical and Occupational Therapy

Menopause encompasses more than just hot flashes, night sweats, and mood swings. Despite being a common phase affecting roughly half of the population, menopause is often misunderstood, both by the public and many healthcare providers. This gap in knowledge can lead to unnecessary suffering, as many individuals are not fully informed about effective treatments.

Perimenopause, the transitional phase leading up to menopause, typically begins in a person’s 40s, with menopause itself usually occurring in the early 50s. While systemic symptoms like hot flashes and mood changes are well-known, many people also experience less obvious but equally impactful genitourinary symptoms. These can include painful intercourse, urinary urgency, frequent urination, leakage, burning sensations, recurrent vaginal and urinary tract infections, and vaginal dryness. Collectively, these symptoms are part of the Genitourinary Syndrome of Menopause (GSM). Additionally, many women experience pelvic floor dysfunction, which affects nearly 50% of women by their 50s and can overlap with GSM symptoms.

While systemic hormonal therapy is commonly used to manage menopause symptoms, it may not address the specific needs of those experiencing GSM. The North American Menopause Society recommends the use of vaginal estrogen as an effective treatment for alleviating GSM symptoms and improving quality of life.

Differential Diagnosis:
GSM or Pelvic Floor Dysfunction

Symptoms of pelvic floor dysfunction and Genitourinary Syndrome of Menopause (GSM) can overlap and include:

  • Urinary urgency, frequency, burning, nocturia
  • Feelings of bladder or pelvic pressure
  • Painful sex
  • Diminished or absent orgasm
  • Difficulty evacuating stool
  • Vulvovaginal pain and burning
  • Pain with sitting
Pelvic Floor Dysfunction

An experienced healthcare provider, whether a pelvic floor physical and occupational therapists or a medical doctor, can conduct several assessments to diagnose pelvic floor dysfunction, hormonal deficiencies, and pelvic organ prolapse. These evaluations include a vulvovaginal visual examination, a Q-tip test to pinpoint areas of pain, and a digital manual examination.

Without appropriate medical management, all women may eventually experience symptoms of Genitourinary Syndrome of Menopause (GSM). Many are unaware that a pelvic floor physical and occupational therapy evaluation can be highly beneficial for addressing the musculoskeletal issues contributing to their discomfort. Combining pelvic floor physical and occupational therapy with medical treatments can be crucial for improving sexual enjoyment and resolving urinary and bowel problems.

Virtual pelvic floor therapy for menopause—contact us to get started!

Why didn’t someone tell me?

This question is asked frequently. It’s important to note that the term “Genitourinary Syndrome of Menopause” (GSM) only became officially recognized in 2014. Advocacy from leading medical societies aimed to educate the healthcare community about the unique hormonal needs of the genitourinary tract. While pelvic floor physical and occupational therapy is gaining recognition, there remains a significant gap in awareness and the availability of qualified practitioners to support those experiencing these symptoms.

gentio-urinary 1
gentio-urinary 2

Hormone deficiency can lead to itching in the labial and vaginal areas. Additionally, other dermatological conditions, such as Lichen Sclerosus and cutaneous yeast infections, should also be considered.

During menopause, individuals are particularly susceptible to frequent vaginal and urinary tract infections due to:

  • pH and tissue changes
  • incomplete bladder emptying
  • pelvic organ prolapse compromising urinary function

Recurrent infections are a major contributor to pelvic floor dysfunction. It’s crucial to address these infections promptly, as ongoing visceral-somatic input from untreated infections can lead to increased pain and further dysfunction even after the infection has been resolved. Without appropriate hormone therapy, infections may persist, leading to severe consequences. Untreated infections can cause unprovoked pain, make sexual activity difficult or impossible, and undiagnosed urinary tract infections (UTIs) may progress to kidney issues and other serious complications.

We recommend consulting with a menopause specialist to effectively monitor, prevent, and treat Genitourinary Syndrome of Menopause (GSM) since these issues are both significant and manageable. It’s important to normalize discussions about GSM; there’s no need for embarrassment. With appropriate care, individuals can lead fulfilling lives. Combining virtual pelvic floor physical and occupational therapy with medical management is essential for optimal results.

Treatment:

How We Can Help You

pelvic pain rehab

If you’re experiencing sexual dysfunction, it’s beneficial to consult a pelvic floor physical and occupational therapists online. They can assess whether any issues with your pelvic floor are contributing to your symptoms. During your initial virtual evaluation, the therapist will review your medical history, including previous diagnoses, treatments, and their effectiveness. They understand that many patients feel frustrated by the time they seek help.

The therapist will examine your nerves, muscles, joints, tissues, and movement patterns. After the assessment, they will discuss the findings with you and set both short-term and long-term therapy goals. Typically, physical and occupational therapy sessions occur once or twice a week over a period of approximately 12 weeks. Your therapist will also coordinate with other specialists on your treatment team and provide you with a personalized home exercise program. Our goal is to support your recovery and help you achieve the best possible quality of life.

Get virtual pelvic floor therapy for menopause. Book your online consultation today!

A girl with writting Board

Treatment:

How We Can Help You

Related Blogs:

By Stephanie A. Prendergast, MPT, Cofounder, PHRC Los Angeles

 

Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) is considered a chronic overlapping pain condition (COPC) and it is common, affecting up to 12 million people in the United States alone. The good news is – it’s treatable!

 

Symptoms of IC/PBS can include, but are not limited too:

  • Urinary urgency, frequency, and pain in the absence of infection. A urinalysis should always be utilized to rule in or out an actual infection.
  • Lower abdominal pressure – People may experience symptoms of pressure between the umbilicus and the pubic bone.
  • Pain upon the bladder filling or emptying – Patients may report that they can feel their bladder filling, a sensation we should not be aware of under normal circumstances. Others may report they feel pain or pressure after they void.

 

A host of symptoms exist under the term ‘Interstitial Cystitis.’ Some patients have all the symptoms, others have various combinations of symptoms that may be consistent or intermittent.

Symptoms of IC Pt 2 (1)

Let’s continue our breakdown of these symptoms below:

 

Painful Sex

Penetrative intercourse can result in superficial or deep dyspareunia, vaginal burning, or an increase in urinary urgency.

 

Painful Orgasm

An orgasm is a rapid muscle contraction of pelvic floor muscles. The majority of people with an IC diagnosis have pelvic floor dysfunction and therefore may experience pain with orgasm.

 

Generalized Pelvic Pain

Many people who have the symptoms of IC/PBS may also suffer from vulvodynia, endometriosis, fibromyalgia, TMJ, and migraines. One subset of IC includes body-wide pain, which includes unprovoked pelvic and abdominal pain.

 

Nocturia

This means nighttime urination. People under the age of 35 should not wake at night to urinate. If urgency is causing people to wake up it can be indicative of pelvic floor dysfunction and it is a sign of IC.

 

Resources

Interstitial Cystitis/Painful Bladder Syndrome Resource List

Success Story: Constipation and Urinary Retention Resolved

Good News! Interstitial Cystitis is treatable! A Much Needed Q&A

But is it really Interstitial Cystitis?

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

By PHRC Admin Team

 

Pelvic health is a critical aspect of overall well-being, yet it was often overlooked in the past. Today, we recognize the importance of this specialized field of medicine and the impact it has on millions of lives. Let’s take a trip back in time to explore how the field of pelvic health came to be.

 

The Early Days: Research and Awareness

The foundations of modern pelvic health can be traced back to the late 20th century when researchers began investigating the importance of pelvic floor muscles and their effect on various health issues. This increased awareness led to the development of specialized training and certification programs for healthcare professionals focusing on pelvic health.

One notable pioneer in this field was Dr. Arnold Kegel, who introduced the concept of pelvic floor exercises in the 1940s. His research on the effectiveness of these exercises for treating urinary incontinence laid the groundwork for future advancements in pelvic health.

The Women’s Health Movement: A Catalyst for Change

The women’s health movement of the 1960s and 1970s played a pivotal role in bringing attention to women’s unique health needs, including those related to pelvic health. This movement broke down barriers and shed light on topics that were often considered taboo, leading to the development of new treatments and therapies for female patients.

For example, during this period, biofeedback emerged as a valuable tool for helping women regain control over their pelvic floor muscles. This technique uses sensors to provide real-time feedback on muscle activity, allowing patients to better understand and control their body movements.

Addressing the Needs of an Aging Population

As life expectancy increased, so did the prevalence of age-related health issues, including those related to pelvic health. Healthcare professionals recognized the need to address these problems in older adults and began incorporating pelvic health care into geriatric medicine.

This shift led to the development of new therapies and treatments designed specifically for the unique needs of older patients, such as pelvic floor muscle training, bladder retraining, and electrical stimulation.

A Multidisciplinary Approach: The Birth of Comprehensive Pelvic Health Care

Over time, it became clear that a comprehensive approach to pelvic health was necessary. This realization led to the collaboration of various medical professionals, including urologists, gynecologists, colorectal surgeons, and physical and occupational therapistss, to provide holistic care for patients with pelvic health concerns.

This multidisciplinary approach has been instrumental in improving patient outcomes and addressing complex issues related to pelvic health, such as chronic pelvic pain, sexual dysfunction, and postpartum recovery.

The Future of Pelvic Health: Continuing the Journey

Today, the pelvic health field is well-established and continues to evolve as new research emerges. It plays a crucial role in addressing a range of health issues for both men and women, helping to improve the quality of life for countless individuals.

As we look to the future, it’s essential to continue prioritizing pelvic health research, education, and awareness. By doing so, we can help ensure that this vital field of medicine remains at the forefront of healthcare, providing hope and healing for those who need it most.

 

What is the Importance of PFPT?

Pelvic floor physical and occupational therapy (PFPT) is a specialty of physical and occupational therapy dedicated to the assessment and treatment of pelvic floor dysfunction. It can help alleviate symptoms of urinary incontinence, constipation, pain with intercourse and more. PFPT has become increasingly important in recent years as more research has been done on the causes and treatments associated with pelvic floor dysfunction.

Understanding how to properly assess and treat each patient’s specific condition is key to successful PFPT treatment plans. This involves using techniques such as myofascial release, biofeedback and exercises tailored specifically for each patient. Additionally, modalities like electrical stimulation or ultrasound may be used to reduce pain associated with weakness or tightness in core muscles.

For many people, PFPT can have positive long-term effects on their quality of life through improved functioning of their pelvic floor muscles and reduction or elimination of painful symptoms. Those who are prenatal or postpartum can also benefit from early assessment and treatment as it can help avoid complications down the road as well as providing relief from existing conditions.

Overall, PFPT offers a great opportunity for those suffering from pelvic floor dysfunction to get relief from their symptoms while improving their overall health and quality of life. It is an important specialty that should not be overlooked when seeking treatment options for pelvic floor issues.

 

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

YouTube Channel,

TwitterInstagramTik Tok

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

By Emily Tran, PHRC Westlake Village

 

September marks Gynecologic Cancer Awareness Month, an important time to raise awareness about the importance of early detection and preventive measures for several types of gynecologic cancers.

 

Gynecologic cancers refer to several different types of cancer that affect women’s reproductive organs, including cervical, ovarian, uterine, vaginal and vulvar cancer. While these cancers are commonly diagnosed in women over age 50, it is important to be aware of the various symptoms and risk factors associated with each type so that proper screening can be performed.

 

For example, cervical cancer is often caused by the Human Papillomavirus (HPV) and can typically be prevented through vaccination or a regular pap smear test. Uterine cancer can also be detected early with regular screening; however, symptoms such as abnormal bleeding or pelvic pain should not be overlooked as they could indicate more serious issues. Ovarian cancer may present with subtle symptoms such as bloating or changes in appetite but can also present with no warning signs at all. It is important to speak with your doctor if you experience any of these signs or symptoms as early detection is key to successful treatment.

 

It is also critical to recognize certain risk factors for gynecologic cancers such as genetics and family history; racial/ethnic background; environmental exposures; obesity; smoking; menopausal hormone therapy and previous history of breast or ovarian cancer (source: American Cancer Society).

According to the American Cancer Society, an estimated 79, 844 new cases of gynecologic cancer will be diagnosed in the U.S. in 2021 and around 24,580 women are expected to die from one of these types of cancer this year. 

 

Gynecologic cancers account for approximately 10% of all new cancer cases among women each year and 6% of female cancer deaths annually (source: National Cancers Institute).  

 

Additionally, the mortality rates for gynecologic cancers vary widely from type to type; cervical cancer mortality is much lower than that for ovarian and uterine cancers (source: American Cancer Society

 

Gynecologic cancers not only affect the reproductive organs, but also have a significant impact on pelvic health. As such, many women experience physical and emotional changes after being diagnosed with gynecologic cancer or undergoing treatment for it. Common health problems associated with gynecologic cancer include: pain and fatigue, urinary and bowel difficulties, lymphedema (swelling caused by an accumulation of fluid), infertility, sexual dysfunction, depression, anxiety and other psychological issues (source: American Cancer Society). 

 

Pelvic rehabilitation can help improve physical function, reduce symptoms related to pelvic floor dysfunction as well as decrease both pain levels and the risk of recurrence or progression of the disease (source: International Pelvic Pain Society). With the right support from experts in the field, gynecologic cancer survivors can be empowered to manage their pelvic health post-cancer treatment and reclaim their lives!

 

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical and occupational therapists will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical and occupational therapists will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical and occupational therapists will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical and occupational therapistss focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical and occupational therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.